Buying New Equipment for Your Rehab Practice

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March 2002

By Joe Black, PT, SCS, ATC

Sales reps, pricing, planning, and dependability are all important considerations when making purchasing decisions.

The rent is due, payroll is Friday, and your clinic needs a new piece of equipment. You can't decide whether to lease or purchase, whether to buy a maintenance agreement, or even if the equipment purchase is necessary in the first place.

You are not alone. For those in a position to make decisions on the purchase of new or replacement equipment, these are questions without easy answers. Most equipment purchase decisions are based on three factors: which sales rep is the most likeable, what product is the least expensive, and which product is most popular.

Well, not quite. It seems more appropriate to say those purchase decisions are based on careful planning, detailed product research, and service/dependability. But few private practice owners are that well prepared.

The Rap on Sales Reps
Often, your best source for product information is the sales representative. One of my area's earliest sales representatives was the region's primary provider of transcutaneous electrical nerve stimulation (TENS) units. Hard work and lots of experience gave him a greater knowledge of his product than most of the professionals he dealt with (a degree in physics did not hurt either).

Sales representatives are excellent sources of information and can do much of the product research for you. You should expect good sales reps to have professional documentation on the efficacy of their product.

It is not possible to listen to the full spiel of every salesperson who shows up at your door, but a good relationship with several key people can help you be a better clinician and administrator.

Treat the first visit with prospective sales reps like an interview. Do not try to learn much about their product line: learn who they are. Emphasize the relationship part of the arrangement. Meet with sales reps, but on your terms. Tell them what you want to see and how much time you have before they arrive. Your time and theirs will be used much more efficiently that way. You need to be able to trust their advice. You need to be able to depend on them to do what they say. And only then do you let them educate you about their product.

Price is often one of the least important considerations. A piece of equipment that you do not really need is not a bargain at any price. It is important to judge the quality of a product. If all you look for is the lowest price, you might find yourself saddled with an inferior product. You need to decide what you need and only then find out what is available.

Before purchasing anything, prioritize your purchases. Is it important to have the best available? Do you need the Ferrari or will the Ford do? Purchases made strictly on the basis of what is hot are irresponsible. You can presume that a popular product has some merit but you should never assume that it will work for you or your clinic.

Looking Into the Crystal Ball
It is very difficult to predict the future. What are the future trends in the delivery of patient care? What is the future for your referral base? What services will you develop this year? Next year? Five years from now? Sales reps are not the source for this information. You want to talk to other professionals in similar practice settings. Talk to your referral sources to see what direction their practices are taking.

You may not think that continuing education has much to do with purchase decisions, but that assumption is a mistake. Staying abreast of the latest findings in rehabilitation science can help you decide what the future holds.

Consider the broadening body of knowledge concerning the prevention of falls. There has been significant evidence for years as to the morbidity of falls, particularly in the geriatric population. More recent research has found that intervention programs focused on balance training, activities of daily living instruction, endurance, gait performance, and leg strength can effectively reduce the incidence and severity of falls. Falls assessment and prevention programs should become huge in rehabilitation; it is an arena that not only provides an incredibly valuable service but also broadens the scope of physical therapy practice.

But it is still difficult to predict what will happen tomorrow. That is why doing your homework is crucial. Then, when you either are totally convinced that you know exactly what to expect or are completely confused because you have no idea, take 2 weeks off from the decision and think about it.

What about those decisions that do not give you the luxury of waiting? A crucial piece of equipment breaks down and the patients are waiting. If you have equipment whose absence would restrict clinical functions for more than a week, then you need to have a maintenance agreement on that piece of equipment. Your agreement should stipulate a 48-hour response time. More than 48 hours and the maintenance agreement is not very valuable. Faster than 48 hours is not reasonable to expect.

And how long do you keep repairing an old piece of equipment before you finally consider replacing it? You may feel sentimental about an old, reliable piece of equipment (we are still using one machine that dates to 1981), but a good cost analysis can help you make those decisions.

How many days per month is that equipment down for repairs? Is it growing increasingly difficult to find parts or get it repaired?

Rigorous Research Required
Detailed research is really the backbone of your purchases. Read everything available, ask questions, and talk to others. One of the best methods is to visit the exhibit hall at major conventions. These are incredible opportunities to judge products as well as services.

Last year, we were looking at computerized documentation. Almost every company that provides software and/or hardware for computerized documentation was at the American Physical Therapy Association's Combined Sections Meeting in San Antonio. I arrived with limited knowledge but preconceived notions about what I wanted. When the exhibit hall doors first opened, I casually strolled the entire hall, making mental notes of what products were there that I might want to revisit. I spent a couple of hours with each of those vendors offering computerized documentation. I learned how much I did not know. I took their literature and spent some time with it that evening.

The next day, I returned a much more knowledgeable consumer. It turns out that the products I thought would be the best were a distant second to another system that I had not even considered prior to arriving at the conference.

Visiting other clinics that are already using the product that you are interested in is also useful. Vendors usually have a good list of reputable clinicians who will welcome your visit or call. This gives you the opportunity to look at the product in use and get a (usually) unbiased opinion of the product.

Service & dependability
You must make sure that the products you buy are sturdy and dependable. The easiest way to do that is to deal only with companies with a proven track record. Unfortunately, that puts you well behind the cutting edge of technology, because it is often the start-up companies that are venturing into new arenas with innovative product lines.

Sometimes, you just have to depend on product research and your own experience to judge a new product. It also pays to deal with a sales representative whom you know. If your sales rep will stand behind the product, then you can likely trust it.

With heavy use, any equipment short of a dumbbell will break down, which is why service contracts are important on all major pieces of equipment. Some of our most critical equipment is serviced by a company that will fly a repairperson in from the Northeast within 24 hours of our call.

Product loyalty has yet to be mentioned, yet loyalty to a proven product can be a win-win situation. The company with a broad base of loyal customers will be more financially stable and better able to serve its customers. Loyalty to a particular product means that you have a far greater understanding of how to best use that product, which ultimately results in enhanced patient care. And isn't that what it is all about anyway? ®

Joe Black, PT, SCS, ATC, is CEO and president of the private physical therapy practice, Appalachian Therapy, in Maryville, Tenn.

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March 2002